A pulmonary embolism is a blood clot that travels
to the lungs. Often, the clot forms in another part of the body, usually in
the veins of the legs. Large clots can be fatal. Pulmonary embolism is estimated
to occur in one to two people per 1,000 each year in the United States. The
December 3, 2003, issue of JAMA includes an article
about diagnosing pulmonary embolism.
Sudden chest pain
Cough with blood
Lightheadedness and fainting
Bluish tint to skin
Long periods of immobility (such as bedrest because of an illness)
Taking oral contraceptives
Previous stroke or heart attack
Pulmonary embolism can be difficult to diagnose because the symptoms
are broad and resemble those of other diseases. Results of the patient's history
and physical examination are very important. Some other tests that may be
Arterial blood gases—measurement of oxygen and carbon dioxide
levels in the blood
D-dimer assay—a blood test for evidence of blood clots
Ultrasound of the legs—sound wave images to detect blood
clots in the veins
Lung scan—test of blood flow through the lungs
Spiral computed tomography—detailed computerized x-ray imaging
Pulmonary arteriogram—injections to show the arteries in
the lungs to detect blood clots
Immediate treatment usually includes giving injectable anticoagulants (blood thinners)—such as heparin, followed by warfarin (an anticoagulant taken
by mouth)—to stabilize the clot, prevent additional clots, and restore
normal blood flow in the lungs. Oxygen and sedatives may be given to make
the patient more comfortable. If the clot is large, thrombolytic ("clot busting") drugs may be needed to remove it.
American Heart Association 800/242-8721http://www.americanheart.org
National Heart, Lung, and Blood Institute 301/592-8573 http://www.nhlbi.nih.gov
To find this and other JAMA Patient Pages, go to the Patient Page link
on JAMA's Web site at http://www.jama.com.
A previous Patient Page on pulmonary embolism was published in the February
14, 2001, issue.
Sources: American Heart Association, National Heart, Lung, and Blood
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TOPIC: LUNG DISEASE
Parmet S, Lynm C, Glass RM. Pulmonary Embolism. JAMA. 2003;290(21):2898. doi:10.1001/jama.290.21.2779